Association between blood-aqueous barrier disruption and extent of retinal detachment.

PURPOSE: To investigate the association between anatomical features of rhegmatogenous retinal detachment (RRD) and the extent of blood-aqueous barrier disorder measured by non-invasiv laser flare photometry. METHODS: Retrospective evaluation of consecutive patients with RRD that underwent surgery between November 2016 and October 2018. Descriptive evaluation of pre- and postoperative parameters and correlation to preoperative laser flare value, extent of retinal detachment and re-detachment rate were performed. RESULTS: 266 patients (mean age 62.73 ± 10.40 years, 62.8% male) were included. Mean preoperative flare value was 11.0 ± 11.9 pc/ms. In pseudophakia flare values were higher than in phakia (12.7 ± 10.4 pc/ms versus 9.8 ± 12.9 pc/ms; p = 0.042). Flare increased and correlated significantly with the number of affected retinal quadrants (Q) (1 Q 6.4 ± 3.3 pc/ms; 2 Q 10.5 ± 8.8 pc/ms; 3 Q 15.6 ± 9.1 pc/ms; 4 Q 27.5 ± 33.3 pc/ms; p < 0.001; r = 0.40). Macular status correlated significantly with flare values (macula on 8.6 ± 7.1 pc/ms, off 13.1 ± 15.0 pc/ms; p = 0.004; r = 0.17). CONCLUSION: The level of objective tyndallometry in RRD seems to be influenced by lens status and extent of retinal detachment. Thus, the greater the affected retinal area is, the more blood-aqueous barrier disruption seems to be present.

Lens status and degree of lens opacity influence laser flare photometry (objective tyndallometry).

PURPOSE: Objective tyndallometry using laser flare photometry can be utilized e.g., in management of uveitis. Previous studies showed a significant difference in flare values between pseudophakic and phakic eyes. We investigate a potential association between the degree of lens opacification and flare value in a large cohort phakic eyes. METHODS: Retrospective, non-interventional single center study. Laser flare values of 460 healthy fellow eyes from two large cohorts (primary rhegmatogenous retinal detachment (RRD), macular holes (MH)) were correlated with lens status, degree of lens opacity, and age. RESULTS: Out of 460 patients (mean age 64.6 ± 11.2, 57% male) 30.4% were pseudophakic (70.2 ± 10.9) and 69.6% phakic, of which 47.8% showed a clear lens (57.3 ± 9.1), 43.2% an mild cataract (65.2 ± 9.0) and 9.0% a moderate cataract (73.5 ± 9.0).In pseudophakia, flare (8.14 ± 4.6 pc/ms) was significantly higher compared to phakia (6.4 ± 3.9 pc/ms; p < 0.001). In phakic eyes, flare values increased significantly with increasing lens opacity (clear lens 5.3 ± 2.8 pc/ms; mild cataract 7.0 ± 4.0 pc/ms; moderate cataract 9.5 ± 6.1 pc/ms; p < 0.001). In clear lenses and mild cataract, age correlated significantly with flare (two-sided, p < 0.001, clear lenses R = 0.3; mild cataract R = 0.4). In clear lenses, flare values increased with age by 0.09 per year, in mild cataract by 0.17 (regression coefficients). No significant correlation was found between age and flare value in moderate cataract and pseudophakic eyes. CONCLUSION: The level of objective tyndallometry seems to be dependent on lens status, degree of lens opacity and age. These factors should therefore be taken into account when interpreting laser flare values in the future.